Shoji Kumiko, Shirano Michinori, Konishi Mitsuru, Toyoshima Yuko, Matsumoto Miyuki, Goto Tetsushi, Kasamatsu Yu, Ichida Yuji, Kagawa Yasuo, Kawabata Terue, Ogata Hiromitsu, Habu Daiki
Faculty of Nutrition, Kagawa Nutrition University, Saitama 350-0288, Japan.
Department of Infectious Disease, Osaka City General Hospital, Osaka 534-0021, Japan.
Nutrients. 2022 Jan 18;14(3):428. doi: 10.3390/nu14030428.
Maintenance of the cluster of differentiation 4 (CD4) positive lymphocyte count (CD4 count) is important for human immunodeficiency virus (HIV) positive individuals. Although a higher body mass index (BMI) is shown to be associated with a higher CD4 count, BMI itself does not reflect body composition. Therefore, we examined the association of body weight, body composition and the CD4 count, and determined the optimal ranges of CD4 count associated factors in Japanese HIV positive individuals. This cross-sectional study included 338 male patients treated with antiretroviral therapy for ≥12 months. Multiple logistic regression analysis was used to identify factors significantly associated with a CD4 count of ≥500 cells (mm). The cutoff values of factors for a CD4 ≥ 500 cells (mm) and cardiovascular disease risk were obtained by receiver operating characteristic curves. Age, body fat percentage (BF%), nadir CD4 count, duration of antiretroviral therapy (ART), years since the HIV-positive diagnosis and cholesterol intake showed significant associations with the CD4 count. The cutoff value of BF% for a CD4 ≥ 500 cells (mm) and lower cardiovascular disease risk were ≥25.1% and ≤25.5%, respectively. The BF%, but not the BMI, was associated with CD4 count. For the management of HIV positive individuals, 25% appears to be the optimal BF% when considering the balance between CD4 count management and cardiovascular disease risk.
维持分化簇4（CD4）阳性淋巴细胞计数（CD4计数）对人类免疫缺陷病毒（HIV）阳性个体很重要。尽管较高的体重指数（BMI）与较高的CD4计数相关，但BMI本身并不能反映身体组成。因此，我们研究了体重、身体组成与CD4计数之间的关联，并确定了日本HIV阳性个体中与CD4计数相关因素的最佳范围。这项横断面研究纳入了338名接受抗逆转录病毒治疗≥12个月的男性患者。采用多因素逻辑回归分析来确定与CD4计数≥500个细胞/立方毫米显著相关的因素。通过受试者工作特征曲线获得CD4≥500个细胞/立方毫米和心血管疾病风险的因素截断值。年龄、体脂百分比（BF%）、最低CD4计数、抗逆转录病毒治疗（ART）持续时间、HIV阳性诊断后的年数和胆固醇摄入量与CD4计数显著相关。CD4≥500个细胞/立方毫米且心血管疾病风险较低时BF%的截断值分别为≥25.1%和≤25.5%。与CD4计数相关的是BF%，而非BMI。对于HIV阳性个体的管理，考虑到CD4计数管理和心血管疾病风险之间的平衡，25%似乎是最佳的BF%。
